Agenda item

To consider the report of the Director of Public Health, detailing, as previously outlined in the paper presented to Health and Wellbeing Board in November 2022, that Leeds is responsible for the local implementation of the national 10-year drug plan, “From Harm to Hope” and this comes with additional investment, responsibility, and accountability.

The Board considered a report submitted by the Director of Public Health, detailing, as previously outlined in the paper presented to Health and Wellbeing Board on 27^th September 2022, (Minute 12 refers), that Leeds was responsible for the local implementation of the national 10-year drug plan, “From Harm to Hope” which comes with additional investment, responsibility, and accountability.

In attendance for this item were;

·  Magdalena Boo, Head of Public Health for Adults and Health

·  Mark Hindwell, Marketing and Communications Officer, Forward Leeds

·  Lauren White, Service Manager/ Safeguarding Lead - Young Peoples and Young Adults Services, Forward Leeds

·  Hannah Wray Recovery Coordinator, Forward Leeds

The Executive Member for Adult Social Care, Public Health and Active Lifestyles provided an introduction, praising Forward Leeds for their outstanding work, and noting additional investment had been granted, subject to conditions of capacity and service quality increases for patients and families to regain their health within local services.

The following information was highlighted to Board Members:

·  The Harm to Hope initiative had been set up nationally by the Government as a 10 year plan to combat the negative effects of drug use. The three strategic priorities were to break drug supply chains, deliver a world class treatment and recovery system and achieve a shift in demand for drugs.

·  Some funding had been ringfenced, however, future funding had not been secured, creating some uncertainty for services.

·  Plans were ongoing to address any gaps in service provision, access to pathways to recovery and referrals to support.

·  Local to Leeds, the Drug and Alcohol Partnership hold a mental health sub-group, which focused particularly on addressing the needs of younger people.

·  Key stakeholders were noted as Forward Leeds, St Anne’s, Change Grow Live, Leeds City Council, West Yorkshire Police and LTHT. Crime and associated impacts on care was a key topic and progress was tracked locally with positive and negative outcomes monitored.

·  The integrated services had received an outstanding CQC rating.

·  Increased service capacity and care were priorities to make a difference to individuals and communities through increasing staffing, decreasing case loads and waiting times to improve access and recovery rates.

·  The service had joined the Inclusive Recovery Cities programme.

·  There was an aim to encourage more people who were in need to engage with services and to reduce the stigma attached to addiction.

·  It was noted that people on a journey to recovery were assets to the community and four times more likely to participate in beneficial community work such as volunteering.

·  A young person’s service was targeted at under 18s and young adults and included recovery and outreach workers, social care, schools and violence reduction services.

·  An advanced care team was responsible for supporting people with complex needs, such as self-neglect and homelessness. This branch of the service was linked to palliative care and end of life services and also connected people to other relevant services.

·  Engagement with unsheltered people was significant as well as hidden vulnerable people who may be living in social housing or be unknown to health services; outreach work was integral to achieve strategic aims and a van was available to the service to meet people in an environment they may be more comfortable in.

·  Harm reduction measures were in place in cases where people who are not in a position to be able to access immediate care programmes. There were ten Care and Harm Reduction Workers that conduct positive public work, such as clearing reported needle litter.

·  Resuscitation plans were in place to save lives and link people to treatment, a nasal spray to help with resuscitation was available.

A video was played for Members which had been conducted with the 5 Way Recovery Academy, detailing people’s journey and lived experience of their recovery from addiction to drugs and or alcohol. It was outlined that supporting recovery positively gave back to the community, acknowledged that recovery was important for the city, there was life after addiction, services supported individuals and there were many cases displaying positive outcomes.

The Board discussed the following matters:

• The individuals that had spoken in the video were brave for sharing their stories and thanked for their contributions.
• it can be difficult to determine the appropriate time to signpost people to services, such as traumatic events within emergency services. It was outlined that early intervention was best practise, based on evidence and also it may be rational to refer people at times of crisis as this is often a ‘teachable moment’ and they may recognise their need for help in recovery.
• It was noted that anyone under the age of 16 that was in A+E due to drug or alcohol related accidents or ailments were automatically referred. There was also written information about Forward Leeds services available within the waiting rooms.
• Training for health and care staff had been conducted to assist with identifying cases where drugs and alcohol were involved for branches of care, such as midwifery. Alice Turner was thanked for her work on this training, and it was noted she was willing to attend a future Board meeting to identify best practise pathways for identifying causes for concern.
• A hospital in-reach team visited people in hospital to raise awareness of the services and also provide leaflets to signpost staff when to refer patients.
• Recovery services could be better linked to mental health services, such as the Mental Health Hubs. It was noted there were strong links with the community mental health programme as substance abuse and mental health issues were often interlinked and further work on commissioning and integration could explore options to bring services closer.
• Dual diagnosis of mental health and addiction or recovery pathways were noted to be a front line issue.
• There were three Harm Reduction Officers in post who conducted work out in the community and also supported treatment in crisis assessments.
• How information and practises can be shared across the wider health and care system was discussed. There was an opportunity in light of the exceptional outcomes of the service, with no other city holding an outstanding CQC rating, to apply service design, culture and partnership working to other health programmes.
• With future funding insecure, lessons could be learnt for system sustainability.
• Although referrals were not implemented through the Family Drug and Alcohol Court, the service was open to working with them to advance ongoing collaboration with Children’s Services and to pool resources.
• Meetings with the A+E Navigators team were ongoing to ensure referrals were made to the service as well as signposting young people to appropriate services to address subjection to violence and abuse.
• As historically complex needs cases had often been under provided for or less understood, the outcomes of the services had been positive. To support the physical health of older patients and palliative care pathways it was an aim to provide the best care possible to improve the quality of life for people, and those important to them. Dr. Richard Parker was thanked for his work supporting people through liver disease and end of life care.
• The processes and active work displayed positives as to how far stigma reduction and situational understanding for individuals had progressed in addressing addiction, mental health and recovery.

RECOMMENDED –

a)  That the progress made in local implementation of the national 10-year Drug Plan “From Harm to Hope”, be noted.

b)  That the increased (indicative allocation) investment for Leeds and share evidence and knowledge on needs and gaps to inform investment priorities for 2024/5, noting the very specific restrictions and conditions on the funding, be noted.

c)  That the work to improve screening pathways between healthcare, social care, and treatment, be supported.

d)  That opportunities to make recovery visible, celebrate recovery and support the Inclusive Recovery Cities movement, be sought.